Individual
NYANYIWA VIMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 E VAN BUREN ST, PHOENIX, AZ 85008
(602) 685-3100
Mailing address
PO BOX 52109, PHOENIX, AZ 85072-2109
(602) 685-3100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5009803
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
219411
AZ
Other
Enumeration date
08/22/2017
Last updated
01/04/2019
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